关节注射结合中药辩证治疗膝骨性关节炎

Intra-Articular Injection Combined with Traditional Chinese Medicine Integrated Treatment for Knee Osteoarthritis

目的探讨运用关节注射结合中医药保守综合治疗膝关节骨性关节炎,使用多种方法提高临床疗效,从"简、便、廉"的角度减少患者的痛苦。方法骨科自2005年8月-2010年7月收治符合膝关节骨性关节炎诊断标准患者45例,所有患者均参照中华医学会骨科学分会拟定的《骨关节炎诊治指南(2007年版)》中的诊断标准,符合《中医病证诊断疗效标准》。进行施沛特(透明质酸钠)关节腔注射,结合醋酸泼尼松龙(糖皮质激素)封闭痛点或关节腔注射、根据辨证分型运用中药治疗。结果本组45例膝关节骨性关节炎患者经过辨证施治,规范治疗,总有效率为93.3%,无效率为6.7%。结论运用综合治疗有助于迅速控制症状,特别是痛点的封闭能做到减少毒副作用,降低疼痛,延缓病情的发展;透明质酸钠(SH)是关节液和软骨基质的主要组成部分,有参与细胞外液中电解质及水分调节、润滑关节、抗御感染、参与创伤愈合等多种生理功能,对关节的保护、营养及功能的发挥均起重要作用。改善关节功能和提高生活质量,适合基层医院和社区推广。

Objective To investigate the therapeutic efficacy of intra-articular injection combined with traditional Chinese medicine integrated treatment for knee osteoarthritis. Methods Forty five patients met the diagnostic criteria（osteoarthritis treatment guidelines and TCM syndrome diagnostic efficacy standards） for knee osteoarthritis from Aug. 2005 to Jul. 2010 was enrolled in this study. The intra-articular injection of sodium hyaluronate （ Sofast）, pain spot blocking or intra-articular injection of corticosteroids（ prednisolone acetate）, and traditional Chinese medicine integrated treatment were combined. Results The total efficiency was 93.3 %, and ineffective rate was 6.7%. Conclusion The pain spot blocking can decrease the pain of patients,intra-articular injection of sodium hyaluronate can improve the function of the knees. The combined modality therapy with intra-articular injection and traditional Chinese medicine integrated treatment is effective for knee osteoarthritis, and can be spread in primary hospitals and community outreach.